Lateral Entry Fixation Using Three Divergent Pins for
                              Displaced Paediatric Supracondylar Humeral Fractures

Guy, Stephen; Ponnuru, R; Gella, Sreenadh; Tulwa, Nirmal

doi:10.5402/2011/137372

Cited by 11 publications

(15 citation statements)

References 24 publications

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“…Similar good to excellent results without any loss of fracture fixation with three lateral pinning had shown by Lee YH et al, 7 as well as Stephen Paul Guy, 9 and his colleagues. Loss of fixation was found mostly with Gartland type III fractures treated with two lateral pins, but no failures were noted when three pins were used.…”

Section: Discussionsupporting

confidence: 75%

“…8,12,13,16 As we used only lateral pinning, iatrogenic ulnar nerve injuries had not occurred in all cases. Lee YH et al, 7 as well as Stephen Paul Guy, 9 and his colleagues also did not have any iatrogenic nerve injuries in their series using three lateral pinning.…”

Section: Discussionmentioning

confidence: 84%

“…Various pin configurations have been recommended for the treatment of displaced supracondylar humerus fractures on the basis of choice between the stability versus the risk of iatrogenic ulnar nerve injury. [7][8][9][10] The Flynn criteria is widely used for the final assessment in the treatment of supracondylar fracture. According to the Flynn criteria, the final outcome of the treatment in this study showed 34 satisfactory (77.1% excellent, 14.3% good and 5.7% fair results) and only one unsatisfactory result.…”

Section: Discussionmentioning

confidence: 99%

“…No one developed cubitus varus deformity. Stephen Paul Guy, 9 and his colleagues obtained 21 excellent, three good and one poor result among 25 patients on Flynn's grading using three lateral divergent K-wires. Similarly, Lee YH et al, 7 observed 56 excellent and five good results among 61 patients.…”

Section: Discussionmentioning

confidence: 99%

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Three lateral divergent pinning for displaced supracondylar humerus fractures in children

Tamrakar

Khanal

Acharya

et al. 2015

J Patan Acad Health Sci

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Introductions: Cross or two lateral pinnings are the most commonly done procedures for displaced supracondylar humerus fractures in children. A crossed pin is biomechanically stable than lateral pins, but associated with risk of iatrogenic ulnar nerve injury. Recent studies have shown stable fixation with three lateral pin construct. The purpose of this study was to evaluate the efficacy of three lateral divergent pinning for displaced supracondylar humerus fractures.Methods: Thirty five children with Gartland types III were treated between November 2012 and November 2013. Closed reduction and three lateral divergent pinning was done with image intensifier guidance. Patients were followed up for minimum 6 months. Radiological assessment was done to see union, proper pin placement and loss of reduction. Clinically, patients were assessed by using Flynn criteria.Results: There were 24 (68.6%) male and 11 (31.4%) female children between 2 to 13 years of age with displaced supracondylar fractures, left side 26 (74.3%) and right nine (25.7%) cases. All were successfully managed with closed reduction and three lateral divergent pins within 2-6 days of injury. One radial and one median nerve palsies sustained at injury recovered spontaneously. No iatrogenic nerve injuries occurred. A comparison of perioperative and final radiographs revealed no loss of reduction. Twenty-seven excellent, five good, two fair and one poor results on Flynn’s grading. One patient had a superficial pin-tract infection.Conclusions: Closed reduction with three lateral divergent pins is safe for stable fixation of displaced supracondylar humeral fractures in children.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Three lateral divergent pinning for displaced supracondylar humerus fractures in children

Tamrakar

Khanal

Acharya

et al. 2015

J Patan Acad Health Sci

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“…[9][10][11] Similarly injury to the ulnar nerve was encountered when medio-lateral pinning were attempted. [12][13][14] When we compare our findings of iatrogenic ulnar nerve injury in 2 patients of group A, with none in group B, we find that the most frequent problem faced while performing medial pinning is iatrogenic ulnar nerve injury. Both cases of iatrogenic ulnar nerve injury did not recover within our study period.…”

Section: Original Research Articlementioning

confidence: 85%

Medio-lateral entry pin versus lateral entry pin for displaced pediatric supracondylar fractures: A comparative, prospective study

Kandel

Gupta

Hamal

et al. 2016

J Coll Med Sci-Nepal

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Background & Objectives: Supracondylar fracture is one of the commonest fractures in children. Although the technique of pinning is controversial, percutaneous medio-lateral entry pinning is theoretically considered more stable biomechanical construct. The drawback of this method is injury to ulnar nerve which is not encountered in only lateral entry pinning.Materials & Methods: This was a prospective, comparative and observational study done in 60 patients which was alternately divided into two groups. The first group (A) underwent medio-lateral entry pinning and the second group (B) underwent lateral entry pinning. They were followed for 24 weeks and the outcome was assessed using Flynn’s criteria.Results: At twenty-four weeks, the mean loss of range of motion of elbow in medio-lateral pinning group was 3.70 degrees (SD±1.93) and that in lateral pinning group was 4.23 degrees (SD ±1.38). The mean loss in carrying angle at twenty-four weeks in medio-lateral group was 2.93 degrees (SD±2.19) and that in lateral group was 4.17 (SD±2.24). There were 2 (6.67%) cases of iatrogenic ulnar nerve injury in medio-lateral pinning group. Out of thirty patients, in medio-lateral pinning group, 25 had excellent results, 5 had good results and none had fair or poor results. While out of 30 patients in lateral pinning group, 23 had excellent results, 7 had good results and none had fair or poor results.Conclusion: There is no significant difference in outcome in terms of loss of carrying angle and range of motion between the medio-lateral pinning group and the lateral pinning group at the end of 6 months.Journal of College of Medical Sciences-Nepal, Vol.11(4) 2015: 28-31

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Lateral entry pins and Slongo’s external fixation: which method is more ideal for older children with supracondylar humeral fractures?

Wang

Zhao

et al. 2021

J Orthop Surg Res

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Objective The standard surgical treatment for supracondylar humeral fractures in children is closed reduction and percutaneous pinning. Given the need for greater fixation strength and higher risk of joint stiffness for children older than 8 years, external fixation is often performed for treating supracondylar humeral fractures in older children. The aim of this study was to compare the efficacy of lateral entry pins and Slongo’s external fixation for treating supracondylar humeral fractures in older children. Methods Children older than 8 years who underwent surgery for supracondylar humeral fractures at our hospital for surgery from January 2016 to December 2020 are to be retrospectively assessed. One group (n = 36) underwent internal fixation and percutaneous pinning with three lateral Kirschner wires, and the other group (n = 32) underwent Slongo’s external fixator surgery. The demographic data, operation duration, number of fluoroscopies, and fracture healing time were compared between both groups. The elbow joint function was evaluated 6 months after the surgery on the basis of fracture healing time, lifting angle, elbow joint range of motion (ROM), and Flynn score. The incidence of postoperative complications was also recorded. Results There was no significant difference between the two patient groups in terms of the demographic parameters. Compared to external fixation surgery, Kirschner wire surgery required shorter duration and fewer fluoroscopies (P < 0.05). Nevertheless, the fracture healing time was significantly less (P < 0.05), and the elbow ROM and Flynn scores were higher in the external fixator group compared to the Kirschner wire fixation group (P < 0.05). There was one case of secondary fracture displacement in the Kirschner wire group and one of pin tract infection in the external fixator group. No other iatrogenic injuries or complications were observed. Conclusion Maybe Slongo’s external fixator is a suitable alternative treatment option for supracondylar humeral fractures in children older than 8 years since it can achieve better fixation strength and early restoration of elbow joint movement with a lower risk of joint stiffness.

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Lateral Entry Fixation Using Three Divergent Pins for Displaced Paediatric Supracondylar Humeral Fractures

Cited by 11 publications

References 24 publications

Three lateral divergent pinning for displaced supracondylar humerus fractures in children

Three lateral divergent pinning for displaced supracondylar humerus fractures in children

Medio-lateral entry pin versus lateral entry pin for displaced pediatric supracondylar fractures: A comparative, prospective study

Lateral entry pins and Slongo’s external fixation: which method is more ideal for older children with supracondylar humeral fractures?

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